Medicare: Coordination of Benefits
When you have Medicare and other insurance, each coverage is considered a payer. Coordination of Benefits determines which payer covers costs first. Understanding how payers work together and sharing your insurance details with providers can help ensure bills are processed correctly and reduce unexpected expenses.
Created by DeafHealth with the support of the Patient Advocate Foundation and Pfizer, these videos on Medicare in American Sign Language (ASL) will give you the skills to make informed decisions about your coverage, the benefits offered by Medicare, and how to use your insurance confidently. The videos cover different topics including Medicare Parts A, B, C, D, and Medigap Plans.
- American Sign Language Medicare Guide: https://deafhealthaccess.org/updates/health-insurance/
- English Medicare Guide: https://www.patientadvocate.org/wp-content/uploads/MedicareBenefitsGuide_English-1.pdf
- Medicare Resources Sheet: https://www.patientadvocate.org/wp-content/uploads/Medicare-Resources-Section.pdf
Stay Informed in ASL: We’ve got you covered! Sign up with your email at deafhealthaccess.org/sign-up or follow us on social media for new and current health updates.
Transcript and Video Description
[Video Description: The post has a video thumbnail with blue shading overlaid. The top middle has "Medicare: Coordination of Benefits” in white text with light blue background, accompanied by a yellow bubble with “Medicare” in blue. In the video: A nonbinary person with long, curly brown hair that is shaved on the right side of their head stands in front of the camera. Behind them is a light wooden entry table with a potted monstera plant set against a green wall. They are wearing black pants, a black button down shirt, a light green bandana tied around their neck, and a pair of glasses.
Transcript: If you have Medicare and other health or drug insurance that isn’t Medicare, each one is called a “payer.” When there are multiple payers, there are rules that decide which one pays first. This is called Coordination of Benefits (COB). The first payer pays what they owe (up to the limits of the coverage), and then sends the rest of the bill to the second payer. The second payer only pays if there are costs the first payer didn’t cover, and they may not pay all of the uncovered costs. In some cases, there might even be a third payer. If the first payer denies coverage, the second payer may or may not pay some part of the cost. It’s important to tell your doctor, hospital, and other providers about all of your health or drug insurance plans. This will help make sure your bills go to the right payers in the right order. If you are still working, to ensure your healthcare services get paid correctly, you need to know: Whether your job-based insurance will pay first or second, and if and how it will pay if you don’t enroll in Medicare Part A and/or Part B. Most retiree and small employer plans with 20 or fewer employees require enrollment in Part A and Part B and pay for services second after Medicare pays first. If you don’t sign up for Part A and Part B, your job-based insurance may not cover the costs for the services you get. Employer plans with more than 20 employees pay for services first and Medicare pays second. If you don’t have to pay a premium for Part A, you can choose to sign up when you are eligible or anytime later and you can wait until you stop working or lose health insurance to sign up for Part B, and you won’t pay a late enrollment penalty. If you or your spouse get money from the employer to buy your own health insurance or you or your spouse are still working but don’t have health insurance through that job, Medicare probably doesn’t work with your insurance. Once you sign up, Medicare pays first. Ask your health insurance company if you need to sign up for Part A and Part B when you are eligible. [The screen fades to show a thumbnail of a faded white background of a doctor holding hands with another individual] Deaf. Healthy. DeafHealth. Learn more at www.deafhealthaccess.org. [The screen fades to show a thumbnail of a blue lighthouse] Paf. Patient Advocate Foundation. www.patientadvocate.org.]